A Simplified, Practical Approach to Assessment of Severity of Mitral Régurgitation by Doppler Color Flow Imaging with Proximal Convergence: Validation with Concomitant Cardiac Catheterization

• Objective: To compare the proximal convergence method for quantification of mitral régurgitation with findings on concomitant left ventriculography. • Material and Methods: In 41 patients (22 men and 19 women, 63 ±13 years of age), mitral régurgitation was evaluated concomitantly by Doppler color flow jet area, proximal convergence method, and left ventriculography. A simplified measurement of the proximal convergence, consisting of the aliasing radius and velocity of the proximal isosurface (r2 x V), was used. • Results: Angiographie grade correlated well with the proximal convergence method (r2 x V) but had poor correlation with the Doppler color flow jet area method. All patients with a proximal convergence flow rate of less than 10 cm³/s had grade 1 or 2 mitral régurgitation, whereas patients with a proximal convergence flow rate of more than 20 cm³/s had grade 3 or 4 mitral régurgitation. The severity of mitral régurgitation was indeterminate in patients with proximal convergence flow rates from 10 to 20 cm³/s. • Conclusion: Doppler color flow jet area correlates poorly with angiographie grade of mitral régurgitation. A simplified proximal convergence method is useful for separating grade 3 and 4 from grade 1 and 2 mitral régurgitation in most patients. A group of patients with indeterminate severity of mitral régurgitation remains, however, in whom further assessment is necessary.